Fibrinogen/fibrin degradation products (FDPs) tests are using in many laboratories for the investigation of suspected disseminated intravascular coagulation (DIC). Recently, monoclonal antibodies which react against the specific products of
cross-linked
fibrin degradation, particularly D-dimer have been developed. Because D-dimer confirms that both thrombin generation and plasmin generation have occurred, detection of the cross-linked fibrin degradation fragment (D-dimer) has been reported to be
a
strong evidence for the diagnosis of DIC in patients at risk.
The authors observed concordance rate between FDP test and two different commercial products Diagnostic Stago, American Dade for D-dimer test I 130 specimens referred to the coagulation laboratory in patients with suspected DIC. The scoring
system
based
on clinical condition (etiology, bleeding and organ failure) and results of DIC screen were used to make the diagnosis of DIC I 85 patients. sensitivity, specificity, and diagnostic efficacy as well as positive and negative values of FDP and
D-dimer
assays were observed. Diagnostic efficacy of platelet, prothrombin time and fibrinogen for the diagnosis of DIC were also evaluated together, The concordance rate between FDP test and two different comercial sources for D-dimer test was 51%, with
high
discrepant rate being present. In the diagnosis of DIC, sensitivities of FDP and Stago-D-dimer tests were 81% and 78% respectively, which were higher than those of Dade D-dimer test. On the other hand, Dade-D-dimer test was more specific than
that
of
FDP or Stago D-dimer tests.
Because we found that there are some degree of difference exists in sensitivity and specificity between different commercial products for D-dimer test, it is desirable to use more sensitive FDP of Stago-d-dimer tests than Dade D-dimer test for
the
early
diagnosis of DIC.
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